Testicular Cancer
Testicular cancer is a ‘’Cancer that develops in the testicle. Usually only one testicle is affected, but in some cases both testicles are affected. Testicular cancers starts in the cells that develop into sperm, which are called sperm cells.’’ (Australia, 2015).
It is a cancer that commonly occurs in men. Young men around the ages of 18 to 40 are most at risk of developing testicular cancer. Common symptoms of testicular cancer includes a lump in the testis, the feeling of heaviness in the scrotum and the change in the size and shape of the testicles. Across the Australian demographic, survival rates for testicular cancer have increased in the recent years during “the periods of 1982–1987 and 2006-2010, there is a five-year relative survival increased from 90.7 per cent to 97.6 per cent.” (government, 2014) As well as this, 706 new cases of testicular cancer was presented in Australia during 2010. During this time period, a frequency rate was also conducted which shows a strong increase of 4.2 to 6.5 in a cases of one hundred thousand men who has testicular cancer. Additionally, mortality rates for testicular cancer have also decreased in the past 30 years from 0.5 to 0.1 deaths per one hundred thousand men. The main priority involving testicular cancer would be educating young men on how to improve their health, learn how to look for symptoms and having the confidence to get it checked. The Knowledge of detecting the cancer earlier by young men is proven that Testicular cancer is a highly treatable type of cancer with a very high cure rate which is estimated around 95% if found and treated early. This will then also help boost up the survival rate of cases of testicular cancer presented in Australia. Since testicular cancer is not a preventable cancer in comparison to other cancers such as lung cancer, early dedication and treatment will have a strong possibility that would lead to a better outcomes for men who are diagnose with it. Another reason why there is a huge increase in young men with testicular cancer, is the reluctant attitude to seek professional help, due to the embarrassment factor associated with seeking medical help in the genital region. “The rate of men diagnosed with testicular cancer has grown by more than 50% over the past 30 years” (Australia, 2015) making testicular cancer even more so a priority area in Australia.
The process of assessing testicular cancer firstly involves the doctor to conducting a test to figure out what stage of cancer it is and grading it. This grading of the cancer gives the patient a clear picture of their prognosis and the treatment of the cancer. Correspondingly, the doctor will also need evaluate if the cancer cells have affected other parts of the males’ body. ‘’The main area that testicular cancer can spread to is the lymph nodes in the abdomen and nearby lymph nodes around the pubic area.’’ (Tidy & kenny, 2014). Furthermore, there are multiple tests that can be conducted to discover testicular cancer. One of the test involves the affected persona conducting a self-examination to check for any lumps or irregularities in the testicle. When a lump is discovered, there are further testing to diagnose if the lump is actually a cancerous cell. After this process, an ultrasound is one of the main test as it reveals to the doctor the nature of the lump and if it is fluid filled or solid filled. An ultrasound combined with a blood test for tumor markers will give the doctor a clear idea if the lump is a tumor or the cause of the lump or irregularity. ‘’ In most cases of testicular cancer the testy is removed, this is called an orchiectomy. Additional treatment includes chemotherapy, radiotherapy or both treatments especially if the cancer has spread or in advanced stages of the tumor’’ (Australia, 2015). Risk factors that can lead to someone having a higher chance of developing testicular cancer can be due to undescended testes, previous testicular cancer, previous male infertility, family history and Down syndrome. Undescended testes or otherwise known as cryptorchidism is ‘’ A condition when one or both of the testes have not descended into the scrotum at birth but stay in the abdomen or only move part way down into the scrotum’’. (Blecher, 2014) This is usually found in 3 to 5 boys in every 100. ‘’ Men with a history of undescended testes have about ten times the chance of testicular cancer; the risk may be lower if surgery is used to fix the problem which usually happens before one year of age.’’ (Blecher, 2014). Another risk factor, is previous testicular cancer. This affects ‘’about 1 in 25 men who have had testicular cancer in one testis develop cancer in the other testis’’. (Blecher, 2014). Previous male infertility is also another risk factor in testicular cancer. It is shown that ‘’Men diagnosed with fertility problems, particularly those with a history of undescended testes, may have a greater chance of developing testicular cancer’’. (Blecher, 2014). This is due to ‘’pre cancers cell sometimes found in testicular biopsies from infertile men’’ (Blecher, 2014), however this does not conclude that all pre cancer cells will develop into cancer. Furthermore, family history is also considered as a risk factor. Testicular cancer can also be through family and therefore if a family member is diagnose with the cancer, there is a minor risk that someone else is also going to get it. Men who suffer from Down syndrome will also be at a higher genetic risk of testicular cancer due to genes mutation.
Men, who are diagnosed with testicular cancer, may develop emotional burden, social burden and economic burden. Emotional burden includes the feelings of anxiety and depression. ‘’ Anxiety is more than just feeling stressed or worried. Anxious feelings are a normal reaction to a situation where a person feels under pressure and usually passes once the situation is over, or the ‘stressor’ is removed.’’ (blue, 2014)Nevertheless, for some strange reasons, the feeling of anxiousness happen for no apparent reason and it continues even after the stressful event has passed. Anxiety can be an extremely serious as it makes the person daily life hard to cope. One of the reason why anxiety is formed is because of a cancer diagnosis, such as testicular cancer. Moreover, the symptoms of anxiety can gradually develop over time depending on the situation. Symptoms include hot and cold flushes, racing heart, tightness to the chest, many worries, obsessive thinking and compulsive behavior. All of these feeling, in terms of testicular cancer, can be due to the fear of cancer recurring, sexual performance, concerns about fertility, Change in physical appearance and financial worries. Additionally, depression is another emotion burden that many patient suffers from the diagnostic of testicular cancer. ‘’ Depression affects how a person feels about themselves.’’ (blue, 2014) .Some of the symptoms for people who suffer from testicular cancer and is suffering from depression is not going out, withdrawing from relationship, unable to concentrate, feeling overwhelm, increase drugs and alcohol use, loss of appetite, Trouble getting to sleep, being tired throughout the day, feeling worthless, felling irritated and negatives thoughts. It is best for people with testicular cancer who has anxiety to seek professional help such as talking to doctor, counselling or talk to family and friends. Another burden that patient with testicular cancer will endure, is social burden. This burden strongly affects an individual communication skills. However, this can be assisted by supporting the individual to speak or advise them to go to someone who can assist. Another burden, is economic burden. Economic burden can be from the lack of money a patient has. However, there is Government funding to help. “There is also State and Territory Cancer Councils provide general information about cancer as well as information on local resources and relevant support groups.” (government, 2014) When interviewing a patient who has testicular cancer, the interview help set the base for a provider-patient relationship. Before starting the interview, gathering all the available data such as patient information, past medical records at the beginning of the process as it may help to minimize the time requirement. Keep in mind that only men suffer from testicular cancer, thus some men would feel more comfortable if the interviewer is a male professional. There are three stages of the interview process. The first stage is about building a strong professional relationship with the patient to gain trust from them. Making good first impression on your patient not only affect your relationship but also makes patient feel respected and being heard. One of the first stages is approaching the patient. Greet the patient with their formal name and introducing yourself, hence this is the key to start to a successful interview. Environment is another factor which plays a vital role to make an interview effective one. Setting up a quiet or private room with appropriate lighting and temperature will helps the patient feel secure and confident. Remember to keep the time limit to half an hour to an hour. This will help avoid spending a lot of time and also going out of context. Additionally, the use of therapeutic communication skill should be applied throughout the process. Using the SOLER steps that are sitting squarely, open posture, leaning forward, eye contact and relax. These qualities enhance the effective communication between the nurse and patient. Along with these techniques the interviewer/nurse should have qualities of empathy and active listening. Being empathetic by placing yourself in patient situation and responding accordingly to allows patient to feel as though you understand where they are coming from. In addition to this, the interviewer should not negated the cultural beliefs and practices of the patient. In this case, question whether the patient is comfortable with performing testicular self-examination or Implantation of testicular prosthesis. The next stage involves data collection phase. This is when bulk data from the patient is collected and is goal focused. Gathering a patient history includes collecting the patient medical history and also asking question about recent or remote history that relate to current illness. For example, Men who have history of undescended testes have about ten times the chances of testicular cancer. Also, testicular cancer can be a hereditary, questioning family history is important as well. For example, questions include Are there any members of your family that is a blood relative diagnosed with this disease? Open-ended questions is preferred as it gets in-depth and insightful response and close ended questions limits the response to yes and no. Example of open-ended questions can be, for instance can you tell me if you are having any other difficulties at present? Close-ended questions may be Do you suffer from back pain, chest pain or breathing difficulty? This way we can determine the presence or absence of certain symptoms that patients are experiencing. Final stage is the termination stage where summarizing is done. Giving review of the important point covered during the interview and validating. This makes sure the nurse has understood the patient by what have been said.
There are a variety of ways the current Australian initiatives designed to reduce the impact of testicular cancer. They include treatments such as Chemotherapy, radiotherapy, surgery and palliative treatment. ‘’Chemotherapy is the use of drugs to kill or slow the growth of cancer cells. The aim of treatment is to destroy rapidly dividing cells, such as cancer cells, while causing the least possible damage to healthy cells.’’ (council, 2012). The treatment is considered if the cancer spread around the testicle, if surgery or radiotherapy is performed but is still at risk of cancer spreading or returning and as primary treatment if the cancer is life threating. There are a variety of chemotherapy drugs. One of the drugs that are given to men with this cancer is called Carboplatin. This drug is used in the early stages of ‘’seminoma as adjuvant chemotherapy’’. Other common drugs include bleomycin, etopside and cisplatin. When all the drugs are used together, it is known as BEP Chemotherapy. The process of chemotherapy begins with an injection into the vein by using either a drip or injection into the muscle. This process is given in a cycle, which means that the drug is given every 21 days. The treatment varies from patient to patient, but most men have it in two cycles. As well as this, there are also side effects in treating testicular cancer with chemotherapy such as tiredness, low white blood cell count, vomiting, Nausea, constipation, hair loss, neuropathy, ringing in the ear, erection problems, lower sperm production and airway problems. Take note that every patient is different so some may experience these symptoms, while others don’t. Furthermore, another way to reduce the impact of testicular cancer is radiotherapy. ‘’ Radiotherapy uses x-rays to kill cancer cells. This treatment is commonly used to treat men with seminoma. Men with non-seminoma are not usually treated with radiotherapy.’’ (council, 2012). This process is sometimes given to patient after surgery to prevent cancer cells from spreading and reoccurring. Treatment has to be carefully planned to make sure that many cancer cells are destroyed with little harm to patient tissue. Doctors or radiation therapist may also mark the patient skin with a special ink to make sure that the radiation is directed at the same spot on your body, every time you receive treatment. The process will involve the patient sitting under a machine called linear, which directs the x ray beam at the cancer. The unaffected testicle may be covered with a lead barrier to help preserve the patient fertility. Treatments only takes a few minute, but the process of seeing the radiation oncologist, having the blood tests and setting up machine may take a few hours. The side effects of radiotherapy includes fatigue, dyspepsia, bowel problems, hair loss, bladder irritation and infertility. These side effects usually disappear within a few days of finishing the treatment. Another way created to help reduce testicular cancer is surgery. Surgery is usually an option if the cancer has spread to the lymph glands in the abdomen. The operation that may proceed because of this is called retroperitoneal. Lymph dissection to remove the cancer cell. Men with non-seminoma may have this surgery to prevent the cancer from spreading and men with advance seminoma. The process involve a surgeon making a large incision from the breastbone to below the bellybutton. The organs are moved out of the way and the affected lymph nodes are removed. This process can take several hours depending how serious it is. The side effect involves abdominal pain and tenderness. Medication can be used to relieve the pain. The surgery may also damage the nerves that control ejaculation, which involves the sperm travelling backward into the kidney. This is not harmful to the body but can cause infertility. As well as this, there is also the idea of taking part in a clinical trial which develops new ideas and technology in curing testicular cancer. This involves doctor running trials to test new or modified treatments to test new ways of preventing testicular cancer. Another initiatives to reduce the impact of testicular cancer, is to look after yourself as cancer can both the physical ability and emotions. Looking after yourself includes Healthy eating, staying active, complementary therapies and improving relationships with others.
In conclusion, any male can suffered from testicular cancer and therefore it is extremely important to get it check. If it is discovered too late, there is a chance of removing the whole testicle or even result in the cancer moving elsewhere which result to deaths.

References
Australia, c. c. (2015, March 27). cancer council Australia. Retrieved from cancer council: http://www.cancer.org.au/about-cancer/types-of-cancer/testicular-cancer.html
Blecher, G. (2014, August 27). Andrology Australia. Retrieved from Andrology Australia: https://www.andrologyaustralia.org/testicular-cancer/ blue, B. (2014, October). Beyond blue. Retrieved from Beyond blue: https://www.bspg.com.au/dam/bsg/product?client...prodid=BL/...
Estes, M. E. (2012). health assesment and physical examination. South Melbourne: Australia: Cengage learning Australia. government, A. (2014, August 11). cancer australia. Retrieved from Australian government: http://canceraustralia.gov.au/affected-cancer/cancer-types/testicular-cancer/testicular-cancer-statistics
Rhoads, J. &. (2014). Advanced health Assesment and diagonostic reasoning. Burlington: jones and Bartlet Learning.
Tidy, C., & kenny, T. (2014, november 24). Patient trusted medical information. Retrieved from Patient trusted medical information: http://www.patient.co.uk/health/testicular-cancer-leaflet